Introduction: Individual health behaviors affect both personal health and planetary sustainability. Environmental stress can disrupt rational trade-offs between personal health and ecological concerns, while interventions may recalibrate decision processes. Prior work shows that stress impairs reflective control and amplifies impulsivity, whereas targeted training can restore self-regulation. However, the cross-cultural generalizability of these mechanisms remains largely unexplored.
Methods: Participants from China (N=103) and Germany (N=64), representing Eastern and Western cultural contexts, were assigned to a 2×2 between-subjects design (stress: present/absent×intervention: present/absent). Stress induction and Regulation of Craving Training (ROC-T) were applied, and outcomes were analyzed using both traditional behavioral measures (two-way ANOVA) and drift-diffusion modeling (DDM).
Results:(1) Behavioral outcomes: In China, intervention significantly reduced high-calorie food selection (p＜.001), with a significant stress×intervention interaction on low-calorie food reaction time (p=.041). In Germany, only stress exerted a significant main effect on negative choice reaction times (p=0.01). (2) Cognitive mechanisms: decision thresholds (a) decreased in both groups, reflecting greater decisiveness, consistent with the"stress-impairment—intervention-compensation" framework. However, drift rates (v) diverged: Chinese participants, relying on holistic, context-dependent processing, integrated health-relevant evidence more slowly due to balancing multiple factors(v↓), whereas analytically oriented German participants accelerated evidence accumulation under intervention by selectively focusing on task-relevant cues(v↑). Non-decision times(t) decreased in China but increased in Germany.(3) Bayesian moderation analyses confirmed the core DDM patterns and further demonstrated cultural moderation: country significantly moderated stress—intervention effects on a, v, and t, with significant three-way interactions.
Conclusion:This study provides the cross-cultural evidence of how stress and ROC-T jointly influence health decision-making. Findings indicate that lowering decision thresholds is a universal mechanism, whereas the efficiency of evidence accumulation is culturally contingent. These insights offer guidance for designing culturally sensitive interventions that simultaneously promote individual health and planetary well-being.